46D2240729 CLIA NUMBER - WALGREENS #06961

Laboratory Demographics

  • CLIA Code: 46D2240729
  • Facility Name: WALGREENS #06961
  • Facility Address: 4668 S REDWOOD ROAD
    TAYLORSVILLE, UT
    ZIP 84123
  • Facility Phone: 801 967-4972
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRIAN K. BRAESSE
  • NPI Number: 1013922053
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 46D2240729
LAB Type Pharmacy
Facility Name WALGREENS #06961
Street 4668 S REDWOOD ROAD
City TAYLORSVILLE
State UT
ZIP 84123
Phone 801 967-4972
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/21/2025
Certificate Expiration Date 10/20/2027
Facility Type Pharmacy
Lab Director BRIAN K. BRAESSE

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This page was last updated on: 9/29/2025